A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, body height [android body fat distribution – male fat distribution, the fat is predominantly located on the abdomen and thus the waist-to-hip ratio is ≥ 94 cm in men; ≥ 80 cm in women BMI (body mass index) > 25]; furthermore:
- Inspection (viewing) of the skin and mucous membranes [due toObesity: early musculoskeletal problems – such as knee and hip osteoarthritis, degenerative spine problems; tendency to varicosis (varicose veins), thrombosis (formation of blood clots in the vessels), thrombophlebitis (inflammation of superficial veins) and edema (water retention in the tissues), sweating after meals; due toarterial hypertension: sweating; due toDyslipoproteinemia: xanthomas of the skin and tendons – raised small whitish fatty deposits, eruptive xanthomas – breaking open xanthomas, planar xanthomas of the palms/thighs of the knees – xanthomas lying at the level of the skin, xanthelasmata – symmetrical yellowish-white skin changes on the eyelids and at the inner corner of the eye, arcus lipoides corneae – fatty deposits in the eye; before the age of 50. Occurring before the age of 50 in men / 60 in women, they are indicative of dyslipoproteinemia; due todiabetes mellitus type 2: pruritus (itching), delayed wound healing, skin infections such as furunculosis (bacterial infection of several hair follicles at the same time) or candidamycosis (fungal infection with the fungus Candida albicans), balanitis (acorn inflammation); due tohyperuricemia (gout):
- Acute gout: podagra – severe joint pain in the metatarsophalangeal joint of the big toe; other joints frequently affected are the knee and ankle joints, reddened, overheated
- Chronic gout: tophi – gouty nodules of uric acid crystals – in joints and soft tissues – predilection sites are: Ear cartilage (helix of the auricles, so-called gout beads), eyelids, nostrils, bursa, extensor sides of the elbow joints; joint deformities]
- Auscultation (listening) of the heart [heart failure (cardiac insufficiency), coronary artery disease (CAD)]
- Auscultation of the lungs [decreased total lung capacity, increased work of breathing, especially at night!!]
- Inspection and palpation of the abdomen (belly), inguinal region (groin region), etc. (pressure pain?, knocking pain?, coughing pain?, defensive tension?, hernial ports?, kidney bearing knocking pain?)
- Inspection (viewing) of the skin and mucous membranes [due toObesity: early musculoskeletal problems – such as knee and hip osteoarthritis, degenerative spine problems; tendency to varicosis (varicose veins), thrombosis (formation of blood clots in the vessels), thrombophlebitis (inflammation of superficial veins) and edema (water retention in the tissues), sweating after meals; due toarterial hypertension: sweating; due toDyslipoproteinemia: xanthomas of the skin and tendons – raised small whitish fatty deposits, eruptive xanthomas – breaking open xanthomas, planar xanthomas of the palms/thighs of the knees – xanthomas lying at the level of the skin, xanthelasmata – symmetrical yellowish-white skin changes on the eyelids and at the inner corner of the eye, arcus lipoides corneae – fatty deposits in the eye; before the age of 50. Occurring before the age of 50 in men / 60 in women, they are indicative of dyslipoproteinemia; due todiabetes mellitus type 2: pruritus (itching), delayed wound healing, skin infections such as furunculosis (bacterial infection of several hair follicles at the same time) or candidamycosis (fungal infection with the fungus Candida albicans), balanitis (acorn inflammation); due tohyperuricemia (gout):
- Cancer screening [due tosecondary diseases]
- Neurological examination – [due tosymptoms: paresthesias (insensations) in the legs, central nervous symptoms]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
